抗男性ホルモン療法先行・放射線療法が奏効した前立腺乳頭状腺癌の1例

Abstract

A 76-year-old man complained of initial hematuria and dysuria. Right lobe of the prostate was elastic soft, enlarged and hypoechoic. The serum levels of PA and gamma-Sm were abnormally high. Prostatic biopsy showed papillary adenocarcinoma which was stained by prostatic specific antigen (PA). The cancer was clinically diagnosed as stage C. Antiandrogen therapy was performed. After three months, the prostatic tumor markers decreased to the normal range and the tumor reduced in size without any findings of metastasis on CT scan. Because prostatic biopsy showed viable cancer cells, radiotherapy was added. After six months, the tumor reduced in size without any signs of metastasis on CT scan and prostatic biopsy revealed no viable cancer cells or elevation of the tumor markers. The positive staining for PA and the good response to antiandrogen therapy in our case support the view that papillary adenocarcinoma of the prostate is only a morphologic variant of ordinary prostatic carcinoma (acinous adenocarcinoma).